04/05/2014
YOUR FINANCIAL PRIORITIES & OBJECTIVES
Are you a young individual, an investment savvy expert, a married couple with children, or a business leader on the verge of retirement? Whoever you might be, it is your responsibility to plan your finances today so that you can enjoy a worry-free and financially secure tomorrow.
YOUR PERSONAL INFORMATION
1. First Name:
2. Last Name:
3. Date of Birth (DD-MM-YYYY):
4. Gender (Male/Female):
5. Marital Status:
6. No of Children:
7. Children's Ages:
8. Occupation / Job Title:
9. Annual Income:
10. City of Residence:
11. C.N.I.C #:
12.Telephone Number:
13.Cell Number:
14.Email Address:
YOUR FINANCIAL PRIORITIES & OBJECTIVES
1. Financial Security required for family in the event of your death (life insurance coverage required?):
2. Financial Security required in the event of your Critical Illness (critical illness coverage required?):
3. Financial Security required in the event of your Hospitalization (health insurance coverage required?):
4. Financial Security required against Loan & Liabilities (coverage against loan required?):
5. Retirement Fund & Pension required?:
6. Education Fund for children required?:
7. Marriage Fund for children required?:
8. Wealth Accumulation through regular saving required?:
9. How much you can save on annual basis?:
CURRENT LIFE ASSURANCE PROGRAMME
1. Sum Assured:
2. Premium:
3. Term:
4. Start Date:
5. Purpose:
OUR FEED BACK:
1. Would you like to be contacted?: Yes / No
2. How would you like to be contacted?: Phone / Email / Both
3. Preferred time for calling between: From AM/PM - To AM/PM
4. I want a personal meeting with financial consultant: Yes / No
5. What is a preferred time for meeting? AM / PM
6. Any other Query:
Thanks for your interest.
For Comprehensive Financial Analysis & Planning, kindly email us at: [email protected] all your financial priorities & objectives as mentioned above.
For appointment contact: 0333 3593474, 0305 2537056.